A/HRC/38/36 invitation of the General Assembly holds much promise in terms of elevating the movement towards ending children’s imprisonment. 14. On the other hand, there are many signs of increases in the use of confinement for minor offences and as the default response to problems relating to public safety, social order, immigration, political opposition or “morality”. In some cases, punitive responses are applied disproportionately to address violence or radical extremism among young people. Growing numbers of women are being incarcerated, with a worrying number detained for choices regarding their reproductive health rights. The warehousing of refugees and migrants seeking safety and refuge remains a critical challenge. 15. Improving the conditions of the daily existence of the millions held in locked cells and wards and radically reducing the rates of such imprisonment remain of paramount importance. Equally important is the forging of efforts to fortify and transform communities to support reintegration, inclusive education, socioeconomic empowerment and well-being and, hence, the meaningful fulfilment of the right to the highest attainable standard of mental and physical health. 16. We are at a crucial point in terms of influencing how we conclude this decade and shape the next as regards ending the cultural dependence on confinement and incarceration. II. The right to health in the context of confinement and deprivation of liberty A. Intrinsic links, systemic omissions 17. Ensuring dignity by protecting the right to health has been an objective of prison reform legislation and advocacy since the earliest days of the modern prison. The current structures of confinement produce a vast geography of pain that transcends borders, resource settings and political systems. This is intimately linked to the right to health and well-being, not only of those deprived of liberty and confined, but also of communities, families, children and future generations. It is vital to consider the cyclical and transgenerational harm these systems produce. 11 18. Securing the right to health is necessary for the enjoyment of a range of other rights. In contexts of confinement and deprivation of liberty, violations of the right to health interfere with fair trial guarantees, the prohibition of arbitrary detention and of torture and other forms of cruel, inhuman or degrading treatment, and the enjoyment of the right to life. Violations of the right to health emerge as both causes and consequences of confinement and deprivation of liberty. 19. The Special Rapporteur highlights five ways in which the links between the right to health and confinement and deprivation of liberty are evident: (a) Failure to secure the right to health in early childhood through a comprehensive system of health care contributes to inequalities, poverty, discrimination and poor health in adulthood, feeding facilities of detention and confinement. The vast majority of people in closed settings come from marginalized and low-income communities; (b) Punitive legal frameworks and public policies that make incarceration likelier hinder the realization of the right to health. Such frameworks and policies include laws criminalizing certain behaviours, identities or status (sex work, sexual orientation, gender identity, drug use, HIV status, non-adherence to tuberculosis treatment and exposure to infectious diseases) and health services needed only by women (i.e., abortion); the selective enforcement of loitering, vagabond and public disorder laws against those living in marginalized situations; and prohibitionist drug laws and policies that produce, inter alia, violent illicit drug markets and that lead to incarceration, driving people who use drugs away from community health care while providing little for health care inside prisons. 11 Bruce Western and Becky Pettit, “Incarceration & social inequality”, Daedalus (summer, 2010). 5